Organization
GREAT MINES HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY ROEBACK MA,NCC,LPC,PHR,SHRMC (CEO)
(573) 438-9355
Entity
Organization
Contact information
Practice address
625 CHARITON AVE RM 103, PARK HILLS, MO 63601-9356
(573) 438-9355
(573) 438-7892
Mailing address
PO BOX 761, POTOSI, MO 63664-0761
(573) 438-9355
(573) 438-7892
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/23/2019
Last updated
09/22/2022
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